Individual provider Active NPI

David Shirly, LMHC

  • Mental Health Counselor
  • Naples, FL
National Provider Identifier
1316539893
Registry record updated Feb 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH18828 Issued in FL
Practice address
2500 Airport Rd S
Naples, FL 34112-4880
Phone
(239) 309-1892
NPI assigned
Feb 6, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH18828 FL Primary

Addresses

Primary practice location

2500 Airport Rd S
Naples, FL 34112-4880

Mailing address

2090 River Reach Dr Apt 48
Naples, FL 34104-5277
Phone (239) 595-0076

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260616002177 FL Practitioner - Mental Health Counselor 1951873454 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2090 River Reach Dr
Naples, FL 34104-5220

535 Mack Ave
Kingsley, MI 49649-9220

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH18828FLMDMental Health Counselor

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1612569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612569600000",
    "number": "1316539893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2090 RIVER REACH DR APT 48",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341045277",
            "telephone_number": "239-595-0076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 AIRPORT RD S",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341124880",
            "telephone_number": "239-309-1892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIRLY",
        "first_name": "DAVID",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-02-06",
        "last_updated": "2021-02-06",
        "certification_date": "2021-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH18828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

Verify at the official NPI Registry.